Model Format of Sworn Statement of Loss, Vehicle

Model Format of Sworn Statement of Loss, Vehicle

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Sworn Statement of Loss, Vehicle
Sworn Statement of Loss, Vehicle

TO: ____________________
Regarding: __________________
Policy number: __________________
Policy period: _________________ to __________________

By the above-mentioned policy of insurance, you insured __________________, (hereinafter called the insured) against loss or damage to the automobile described as follows:
Model Year: __________________
Make: ________________
Type of body: _________________
State/License number: _______________ _________

A loss caused by __________________ occurred on ________________, about the hour of _________________ __________, as follows: __________________

The insured was the sole owner of the automobile at the time of the loss or damage and no other person had any interest therein, by lease, bailment, mortgage, lien or other encumbrance or otherwise except: ___________________

At the time of this loss, there was no other insurance on said automobile covering the same periods except: __________________ At the time of this loss, the automobile was used for:
________________________________….

Note: This is just the part of the agreement. To get it drafted completely by legal experts, kindly contact the expert team of Aapka Consultant by clicking here

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